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: InjuryBoard

9-1-1 Tapes Released in Teen Plastic Surgery Death

By Jane Akre

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Stephanie Kuleba 's 911 calls released today.

IMAGE: Stephanie Kuleba from her Facebook page 

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Baco Raton Florida police today released the 911 tapes that show Stephanie Kuleba was sliding into a medical crisis by the time the paramedics got an emergency call last Friday morning.

"She's tubed and they're shocking her," says an unidentified staff member from the outpatient clinic where Kuleba was having corrective breast surgery.

911 Dispatcher: ""Is she breathing?"

Clinic worker: "As far as I know"

The caller then said it's a medical emergency and "We think it's malignant hyperthermia"

911 Dispatcher: "What does that mean?"

Dr. Henry Rosenberg, the President of the Malignant Hyperthermia Association of the United States
says that often EMS doesn't know what MH is.

The dispatcher then said "help is on the way" as Kuleba remained sedated with an endotracheal tube in her mouth.  

Malignant Hyperthermia is a genetic disorder that causes the temperature of the body to rise by up to ten points while the metabolism goes out of control and crashes. 

She was rushed to a nearby hospital, Delray Medical Center, two hours into the surgery and died Saturday.

Kuleba's surgery was elective to correct an inverted areola and uneven breasts. 

Meanwhile tributes on the internet remember the kindhearted girl who was very popular, a high achiever who hoped to one day become a doctor.  

Name:

RIP STEPHANIE JUDE KULEBA YOUR OUR ANGEL **

Type:

Common Interest - Friends

Description:

stephanie was the most amazing girl known to society there was never a time steph didnt believe that you couldnt do something she always had a positive outlook on everything ! anytime u were down steph would give you 1000 reasons to smile . i know your looking down on all of us & giving us the strength to believe i love you my stephie poo

Kuleba had her surgery in the office suites of board-certified Plastic Surgeon, Dr. Steven Schuster of Boca Raton.  

Steven Howard Schuster has a clear and active medical license in the state of Florida, state records show.

His clinic, located at 1905 Clint Moore Rd. Suite 101, in Boca Raton is not an Ambulatory Surgical Center says Teresa Wooten, analyst for hospitals and outpatient services for the state.  

Ambulatory Surgical Centers perform one day procedures with no overnight stay.  They must undergo annual inspections for licensure, risk management and life safety.  Office clinics such as Dr. Schuster's are overseen by the Florida Board of Medicine.

Wooten doesn't believe either type of clinic requires Dentrolene to be kept on hand. That is the only known antidote to MH if administered within 30 minutes of the onset of symptoms.

Wooten says the most stringent requirements are found in surgical clinics that are accredited by one of two bodies - The Joint Commission which accredits hospitals, and the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF).

The Kuleba family attorney, Roberto Stanziale tells the Palm Beach Post that the surgery began at 8:05 yet paramedics were not called until 9:45 that morning.

"If in fact the medical examiner does come back and indicates to us that the cause of death was malignant hypethermia, the questions are now going to be: 'Why wasn't she diagnosed quickly? Why wasn't she administered Dantrolene? And if she was administered Dantrolene, was it done at the appropriate times and in the appropriate dosages?' "Stanziale asked.

Dantrolene has a limited shelf life of three years and costs $2,200 for 36 vials that need to be administered immediately says Dr. Henry Rosenberg, a clinical anesthesiologist until 2002 and now president of the Malignant Hyperthermia Association of the United States.

The American Society for Aesthetic Plastic Surgery reports that younger women are increasingly turning to breast surgery. Between 2002 and 2003, girls under the age of 18 tripled their rate of breast implant surgery from 3,872 to more than 11,000 surgeries.

The FDA and professional organizations recommend a young woman be no younger than 18 if she is to undergo plastic surgery.

Unfortunately for the one in 10,000 to 50,000 who has MH, any type of surgery that involves anesthesia could have triggered MH.

Stephanie Kuleba's My Space motto was "Live Your Life" #

Full post as published by InjuryBoard on March 27, 2008 (boomark / email).

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